Date: 02 May 1948
Cert: 10535
Place of Death: County: Knott City or
Town: Hindman, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Hindman Rural
Full Name: Mrs. Elizabeth FULLER HAYS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Widowed
Husband or Wife of: Jiddy HAYS
Age of husband or wife if alive: Deceased
Birth date of deceased: 15 October 1854
Age: 93 years, 06 months, 17 days
Birthplace: Knott Co., Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: Arch FULLER
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Dicie COMBS
Mother Birthplace: Knott Co., Ky.
Informant: Dicie MILLER, Hindman, Ky.
Burial Place: Hays Cem. - Hindman
Date: 03 May 1948
Signature funeral director: Friends & Neighbors, Hindman,
Ky.
Date received by local registrar: 14 May 1948
Registrar's Signature: Rose B. Craft
Date of Death: 02 May 1948
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Pneumonia
Duration: (blank)
Due to: Age
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: J. W. Duke, M.D., Hindman, Ky.
Date signed: 14 May 1948
Transcribed by Debbie Tamborski, 27 December 2010 |